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基于蒙特利尔认知评估量表的上海市45~65岁社区女性认知水平及轻度认知障碍分布特征的横断面研究

黄雨 陈红 金晨阳 张雨格 蒋伟利 赵琦 朱丽萍 徐飚

黄雨, 陈红, 金晨阳, 张雨格, 蒋伟利, 赵琦, 朱丽萍, 徐飚. 基于蒙特利尔认知评估量表的上海市45~65岁社区女性认知水平及轻度认知障碍分布特征的横断面研究[J]. 中华疾病控制杂志, 2024, 28(9): 1023-1029. doi: 10.16462/j.cnki.zhjbkz.2024.09.006
引用本文: 黄雨, 陈红, 金晨阳, 张雨格, 蒋伟利, 赵琦, 朱丽萍, 徐飚. 基于蒙特利尔认知评估量表的上海市45~65岁社区女性认知水平及轻度认知障碍分布特征的横断面研究[J]. 中华疾病控制杂志, 2024, 28(9): 1023-1029. doi: 10.16462/j.cnki.zhjbkz.2024.09.006
HUANG Yu, CHEN Hong, JIN Chenyang, ZHANG Yuge, JIANG Weili, ZHAO Qi, ZHU Liping, XU Biao. Cognitive health and distribution of mild cognitive impairment of women aged 45-65 in communities of Shanghai: a cross-sectional study based on Montreal cognitive assessment[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(9): 1023-1029. doi: 10.16462/j.cnki.zhjbkz.2024.09.006
Citation: HUANG Yu, CHEN Hong, JIN Chenyang, ZHANG Yuge, JIANG Weili, ZHAO Qi, ZHU Liping, XU Biao. Cognitive health and distribution of mild cognitive impairment of women aged 45-65 in communities of Shanghai: a cross-sectional study based on Montreal cognitive assessment[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(9): 1023-1029. doi: 10.16462/j.cnki.zhjbkz.2024.09.006

基于蒙特利尔认知评估量表的上海市45~65岁社区女性认知水平及轻度认知障碍分布特征的横断面研究

doi: 10.16462/j.cnki.zhjbkz.2024.09.006
黄雨和陈红为共同第一作者
基金项目: 

上海市公共卫生体系建设三年行动计划(2020-2022)妇幼整链式全生命周期健康管理服务模式优化 GWV-9.4

详细信息
    通讯作者:

    徐飚,E-mail:bxu@shmu.edu.cn

  • 中图分类号: R749.1

Cognitive health and distribution of mild cognitive impairment of women aged 45-65 in communities of Shanghai: a cross-sectional study based on Montreal cognitive assessment

HUANG Yu and CHEN Hong contributed equally to this article
Funds: 

Three-year Action Plan of Shanghai Public Health System Construction (2020-2022) Optimization of MCH Whole Life Cycle Health Management Service Model GWV-9.4

More Information
  • 摘要:   目的  了解上海市45~65岁社区女性的认知水平,掌握该人群的轻度认知障碍(mild cognitive impairment, MCI)分布特征及其影响因素。  方法  以上海市8个区自愿参加骨健康队列的45~65岁社区女性为对象,使用一般情况调查表收集人口社会学特征、生活方式、绝经状态、生育史和慢性病患病等信息;使用蒙特利尔认识评估量表(Montreal cognitive assessment, MoCA)测量研究对象的认知功能并筛选MCI患者,采用多因素logistic回归分析模型分析MCI患病的影响因素。  结果  本研究共完成2 205名45~65岁社区女性的问卷调查和MoCA评分,MoCA平均得分为(26.47±3.14)分,MCI患病率为10.25%。多元logistic回归分析模型分析结果显示,MCI患病风险与年龄呈正相关(OR=2.393, 95% CI: 1.345~4.256);相较于小学及以下受教育水平,初中(OR=0.375, 95% CI: 0.240~0.585)、高中或中专(OR=0.185, 95% CI: 0.115~0.298)和大专及以上(OR=0.067, 95% CI: 0.033~0.135)学历女性的MCI患病风险下降;居住在市区(OR=0.563, 95% CI: 0.405~0.785)、饮食荤素均衡(OR=0.678, 95% CI: 0.466~0.986)的45~65岁社区女性的MCI患病风险低于居住在郊区和饮食以素食为主的女性。  结论  上海市45~65岁社区女性MCI的患病率为10.25%。年龄、文化程度、居住区和饮食习惯与45~65岁社区女性MCI患病风险有关。社区开展围绝经期和绝经早期女性人群认知功能评价,可为探讨早期干预策略,延缓MCI进程提供基础依据。
  • 表  1  上海市45~65岁社区女性蒙特利尔量表总分情况

    Table  1.   Total score of Montreal cognitive assessment for women aged 45-65 in community in Shanghai

    特征Characteristic 合计Total
    (n=2 205)
    总分
    Total score
    t/F
    value
    P
    value
    年龄/岁Age/years 15.825 < 0.001
      45~55 1 104(50.1) 27.47±2.35
      >55~65 1 101(49.9) 25.47±3.48
    居住区Residential area 6.965 < 0.001
      市区Urban 1 030(46.7) 26.69±2.82
      郊区Rural 1 175(53.3) 26.04±3.33
    文化程度Education level 151.261 < 0.001
      大专及以上Junior college or above 794(36.0) 27.87±2.01
      高中或中专Senior high school or technical school 693(31.4) 26.52±2.95
      初中Junior high school 581(26.4) 25.23±3.33
      小学Primary school or below 137(6.2) 23.44±4.12
    工作状态Work status 65.544 < 0.001
      在职Incumbented 1 142(51.8) 27.20±2.64
      离退休Retired 917(41.6) 25.73±3.38
      全职在家Housewife 146(6.6) 25.46±3.70
    家庭人均月收入/元Monthly income per capita/yuan 40.017 < 0.001
       < 5 000 832(37.7) 25.56±3.36
      5 000~ < 10 000 730(33.1) 26.98±2.63
      10 000~ < 15 000 337(15.3) 27.13±2.94
      ≥15 000 306(13.9) 27.02±3.25
    婚姻状况Marital status 2.067 0.103
      已婚Married 1 989(90.2) 26.48±3.16
      未婚Unmarried 20(0.9) 27.45±1.91
      丧偶Widowed 66(3.0) 25.71±3.67
      离异/分居Divorced/separated 130(5.9) 26.64±2.53
    生育史Reproductive history 12.933 < 0.001
      有Yes 2 156(97.8) 26.44±3.15
      无No 49(2.2) 28.06±2.03
    绝经状态Menopause status 221.122 < 0.001
      是Yes 1 219(55.3) 25.62±3.41
      否No 986(44.7) 27.53±2.38
    吸烟状况Smoking status 2.148 0.143
      是Yes 26(1.2) 25.58±3.88
      否No 2 179(98.8) 26.48±3.13
    饮酒状况Drinking status 14.250 < 0.001
      是Yes 450(20.4) 26.97±2.55
      否No 1 755(79.6) 26.35±3.26
    饮食习惯Eating habit 38.948 < 0.001
      荤素均衡Balanced diet 1 921(87.1) 26.63±3.07
      素食为主Vegetarian diet 284(12.9) 25.40±3.39
    糖尿病Diabetes 15.841 < 0.001
      有Yes 125(5.7) 25.39±3.69
      无No 2 080(94.3) 26.54±3.09
    高血压Hypertension 8.459 0.004
      有Yes 461(20.9) 26.10±3.38
      无No 1 744(79.1) 26.57±3.06
    骨质疏松症Osteoporosis 1.051 0.305
      有Yes 178(8.1) 26.24±3.10
      无No 2 027(91.9) 26.49±3.14
    恶性肿瘤Malignancy 2.414 0.120
      有Yes 846(38.4) 26.60±3.19
      无No 1 359(61.6) 26.39±3.10
    其他慢性病Other chronic disease 0.165 0.685
      有Yes 110(5.0) 26.59±2.84
      无No 2 095(95.0) 26.47±3.15
    注:①以人数(占比/%)表示;②以x±s表示。
    Note: ① Number of people (proportion/%); ② x±s.
    下载: 导出CSV

    表  2  上海市45~65岁社区女性蒙特利尔量表各认知模块得分情况

    Table  2.   Scores of cognitive modules of MoCA-B for women aged 45-65 in community in Shanghai

    特征Characteristic 执行功能
    Perform function
    流畅性
    Fluency
    定向
    Orientation
    计算
    Calculation
    抽象
    Abstract thinking
    合计Total (n=2 205) 0.73±0.44 1.64±0.52 5.93±0.35 2.79±0.57 2.66±0.72
    年龄/岁Age/years
      45~55 0.80±0.40 1.74±0.46 5.97±0.18 2.87±0.44 2.84±0.48
      >55~65 0.66±0.47 1.54±0.55 5.89±0.46 2.70±0.66 2.48±0.86
    居住区Residential area
      市区Urban 0.78±0.42 1.67±0.50 5.89±0.42 2.78±0.56 2.80±0.50
      郊区Rural 0.69±0.46 1.61±0.53 5.96±0.28 2.80±0.58 2.53±0.85
    文化程度Education level
      大专及以上Junior college or above 0.85±0.36 1.79±0.42 5.96±0.30 2.93±0.29 2.91±0.32
      高中或中专Senior high school or technical school 0.74±0.44 1.66±0.49 5.92±0.41 2.80±0.56 2.72±0.62
      初中Junior high school 0.62±0.49 1.52±0.56 5.93±0.30 2.67±0.70 2.42±0.87
      小学Primary school or below 0.45±0.50 1.23±0.62 5.82±0.48 2.44±0.91 1.92±1.20
    工作状态Work status
      在职Incumbented 0.77±0.42 1.72±0.48 5.95±0.31 2.85±0.46 2.80±0.55
      离退休Retired 0.69±0.46 1.55±0.54 5.91±0.39 2.73±0.64 2.52±0.83
      全职在家Housewife 0.65±0.48 1.62±0.53 5.88±0.36 2.68±0.78 2.42±0.90
    家庭人均月收入/元Monthly income per capita/yuan
       < 5 000 0.65±0.48 1.55±0.56 5.91±0.39 2.71±0.66 2.45±0.88
      5 000~ < 10 000 0.75±0.43 1.68±0.49 5.94±0.34 2.83±0.51 2.77±0.59
      10 000~ < 15 000 0.82±0.39 1.73±0.46 5.93±0.36 2.85±0.44 2.85±0.46
      ≥15 000 0.79±0.41 1.71±0.48 5.96±0.26 2.83±0.56 2.76±0.60
    特征Characteristic 延迟回忆
    Delayed recall
    视知觉
    Visual perception
    命名
    Naming
    注意力Attention
      Ⅰ
    合计Total (n=2 205) 3.44±1.31 2.51±0.71 3.84±0.47 0.96±0.21 1.90±0.35
    年龄/岁Age/years
      45~55 3.65±1.23 2.71±0.54 3.93±0.30 0.98±0.13 1.95±0.24
      >55~65 3.23±1.35 2.31±0.80 3.76±0.58 0.93±0.26 1.86±0.42
    居住区Residential area
      市区Urban 3.66±1.18 2.60±0.61 3.89±0.38 0.95±0.22 1.86±0.40
      郊区Rural 3.25±1.39 2.43±0.78 3.81±0.54 0.96±0.19 1.94±0.29
    文化程度Education level
      大专及以上Junior college or above 3.76±1.17 2.78±0.43 3.94±0.27 0.97±0.16 1.94±0.26
      高中或中专Senior high school or technical school 3.42±1.31 2.49±0.71 3.85±0.45 0.96±0.20 1.91±0.34
      初中Junior high school 3.11±1.38 2.28±0.80 3.76±0.62 0.94±0.23 1.87±0.41
      小学Primary school or below 3.05±1.31 2.02±0.94 3.66±0.62 0.88±0.32 1.80±0.50
    工作状态Work status
      在职Incumbented 3.62±1.25 2.65±0.59 3.89±0.39 0.96±0.18 1.93±0.30
      离退休Retired 3.24±1.34 2.36±0.78 3.81±0.52 0.94±0.23 1.89±0.39
      全职在家Housewife 3.32±1.40 2.32±0.85 3.69±0.65 0.95±0.21 1.84±0.44
    家庭人均月收入/元Monthly income per capita/yuan
       < 5 000 3.23±1.39 2.33±0.80 3.76±0.58 0.94±0.23 1.90±0.37
      5 000~ < 10 000 3.55±1.25 2.62±0.61 3.91±0.33 0.96±0.19 1.91±0.33
      10 000~ < 15 000 3.59±1.25 2.66±0.59 3.89±0.37 0.96±0.19 1.91±0.32
      ≥15 000 3.59±1.23 2.58±0.67 3.87±0.47 0.96±0.20 1.91±0.35
    注:①以x±s表示; ② P<0.05。
    Note: ① x±s; ② P<0.05.
    下载: 导出CSV

    表  3  不同特征上海市45~65岁社区女性MCI情况比较

    Table  3.   Comparison of MCI among women aged 45-65 in community in Shanghai with different characteristics

    特征Characteristic 单因素分析Univariate analysis 多因素分析Multivariate analysis
    OR值value (95% CI) P值value OR值value (95% CI) P值value
    年龄/岁Age/years
      45~55 1.000 1.000
      >55~65 5.587(3.913~7.977) < 0.001 2.393(1.345~4.256) 0.003
    居住区Residential area
      郊区Rural 1.000 1.000
      市区Urban 0.466(0.346~0.626) < 0.001 0.563(0.405~0.785) 0.001
    文化程度Education level
      小学Primary school or below 1.000 1.000
      初中Junior high school 0.441(0.292~0.667) < 0.001 0.375(0.240~0.585) < 0.0001
      高中或中专Senior high school or technical school 0.191(0.123~0.297) < 0.001 0.185(0.115~0.298) < 0.0001
      大专及以上Junior college or above 0.033(0.017~0.063) < 0.001 0.067(0.033~0.135) < 0.0001
    工作状态Work status
      在职Incumbented 1.000 1.000
      离退休Retired 3.034(2.221~4.145) < 0.001 1.065(0.726~1.562) 0.749
      全职在家Housewife 3.539(2.146~5.834) < 0.001 1.116(0.645~1.932) 0.694
    婚姻状况Marital status
      已婚Married 1.000 1.000
      未婚Unmarried 0.000(0.000) 0.998 0.000(0.000) 0.998
      丧偶Widowed 1.913(0.007~3.635) 0.048 1.688(0.830~3.435) 0.148
      离异/分居Divorced/separated 0.490(0.226~1.063) 0.071 0.480(0.212~1.085) 0.078
    家庭人均月收入/元Monthly income per capita/yuan
       < 5 000 1.000 1.000
      5 000~ < 10 000 0.322(0.226~0.458) < 0.001 0.733(0.494~1.088) 0.123
      10 000~ < 15 000 0.277(0.166~0.460) < 0.001 0.931(0.531~1.635) 0.805
      ≥15 000 0.380(0.237~0.607) < 0.001 0.851(0.507~1.428) 0.541
    绝经状态Menopause status
      否No 1.000 1.000
      是Yes 5.643(3.842~8.286) < 0.001 1.655(0.898~3.048) 0.106
    吸烟状况Smoking status
      否No 1.000
      是Yes 1.603(0.547~4.693) 0.389
    饮酒状况Drinking status
      否No 1.000 1.000
      是Yes 0.499(0.329~0.757) 0.001 0.849(0.540~1.334) 0.477
    饮食习惯Eating habit
      素食为主Vegetarian diet 1.000 1.000
      荤素均衡Balanced diet 0.444(0.317~0.623) < 0.001 0.678(0.466~0.986) 0.042
    糖尿病Diabetes
      无No 1.000 1.000
      有Yes 2.085(1.297~3.353) 0.002 1.349(0.807~2.254) 0.253
    高血压Hypertension
      无No 1.000
      有Yes 1.315(0.955~1.810) 0.093
    骨质疏松症Osteoporosis
      无No 1.000
      有Yes 1.484(0.949~2.321) 0.083
    恶性肿瘤Malignancy
      无No 1.000
      有Yes 0.813(0.609~1.086) 0.161
    其他慢性病Other chronic disease
      无No 1.000
      有Yes 1.076(0.581~1.993) 0.815
    下载: 导出CSV
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出版历程
  • 收稿日期:  2024-01-04
  • 修回日期:  2024-05-15
  • 网络出版日期:  2024-10-24
  • 刊出日期:  2024-09-10

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